Experiencing Extreme Hunger in Anorexia Nervosa Recovery: A Qualitative Analysis of Reddit Narratives

OBJECTIVE: Recovery from anorexia nervosa involves psychological and social adjustments that extend beyond weight restoration. Online forums increasingly serve as spaces where recovery experiences are openly shared, including accounts of "extreme hunger" during refeeding-a phenomenon that has not been reported in the clinical literature. This study explores how extreme hunger is experienced in original posts shared within an online forum dedicated to anorexia nervosa recovery. METHOD: Using the Reddit API, 987 analyzable posts from r/AnorexiaRecovery published between July 25, 2023, and January 4, 2024, were collected. An initial exploratory review identified extreme hunger as a recurrent topic warranting focused investigation. Posts explicitly referring to it (n = 92; 9.3%) were analyzed using reflexive thematic analysis. Coding was conducted iteratively through collaborative review, with codes refined, grouped into subthemes, and synthesized into overarching themes. RESULTS: Three interconnected themes characterized experiences of extreme hunger. Participants reported (1) "anxiety over its perceived abnormality," worrying that honoring it indicated binge eating or the development of binge eating disorder. They also described (2) "extreme hunger as a threat to recovery," as it could lead to significant distress, thoughts of suicide, renewed food restriction, and relapse. Finally, users highlighted (3) "a perceived lack of guidance for its management," often turning to online content for answers in the absence of professional advice. DISCUSSION: Extreme hunger emerged as a misunderstood and destabilizing experience during anorexia nervosa recovery. Greater clinical recognition may improve recovery support. Further research is needed to clarify its prevalence, underlying mechanisms, and clinical significance.